Effects of clinical pathways on stroke outcomes at a tertiary rural hospital.
- Author:
Guillermo Lacuesta Manalo III
1
Author Information
- Publication Type:Journal Article
- From: Philippine Journal of Neurology 2023;26(1):33-60
- CountryPhilippines
- Language:English
- Abstract: Stroke is the most common neurologic admission in our Center. Healthcare needs to be sustainable, while maintaining the standard of care. Will codifying acute stroke care into a pre- written clinical pathway reduce mortality, lengths of hospital stay, and costs? We pilot-tested an Acute Stroke Clinical Pathway based on the Stroke Society of the Philippines, Department of Health, and other international guidelines. Mortality rate, lengths of hospital stay, excess hospital costs and complication rates were compared. Those enrolled into the Ischemic Stroke pathway stayed one day less compared to those who were not. The hospital share for mild hemorrhagic stroke, mortality rate for moderate hemorrhagic stroke, and length of stay and hospital share in severe hemorrhagic stroke patients enrolled into a Hemorrhagic Stroke pathway were statistically significantly less. The savings in some patient groups (e.g., in Mild Hemorrhagic strokes) were offset by losses in others (e.g., in Moderate to Severe Ischemic Strokes). Patients enrolled into a stroke pathway were recorded to have more nosocomial infections. The findings show that using a pre-written clinical pathway reduces stroke patient mortality, length of stay, and hospital cost, but only in specific patient groups. The increase in reported nosocomial infections in stroke-pathway-enrolled patients is hypothesized to be due to better reporting.
- Full text:26(1)_4.pdf
